Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN2281788 | MA |
N | 363LC1500X | Nurse Practitioner - Community Health | RN2281788 | MA |
N | 363LP2300X | Nurse Practitioner - Primary Care | RN2281788 | MA |
NPI | 1982011003 |
---|---|
Provider Name | Stephanie Connors |
First Address | Worcester, MA 01609-2924 |
Second Address | Worcester, MA 01609-2924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2014 |
Last Update Date | 21/07/2014 |